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End stage renal disease caused by thromboangiitis obliterans: a case report.

Yun HJ, Kim DI, Lee KH, Lim SJ, Hwang WM, Yun SR, Yoon SH - J Med Case Rep (2015)

Bottom Line: He also had abdominal angina.Renal failure and mesenteric ischemia associated with thromboangiitis obliterans progression was diagnosed.But once it occurs, it can be life-threatening.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Konyang University College of Medicine, 158 Gwanjeo-dong-ro, Seo-gu, Daejeon, 302-718, South Korea. yhj0927@kyuh.ac.kr.

ABSTRACT

Introduction: Thromboangiitis obliterans or Buerger's disease is a nonatherosclerotic, segmental, inflammatory vasculitis that is strongly associated with tobacco products and commonly affects the small- and medium-sized arteries of the upper and lower extremities. However, the disease can, rarely, involve large central or visceral arteries. We report here the case of end stage renal disease due to renal artery thrombosis caused by thromboangiitis obliterans.

Case presentation: A 51-year-old Korean man who had previously required amputation of both great toes due to thromboangiitis obliterans presented with left flank pain and oliguria. Both his renal arteries were occluded on contrast-enhanced abdominal computed tomography and abdominal angiography. He also had abdominal angina. He had no risk factor of thromboembolism from cardiac origin, atherosclerosis except for tobacco abuse, collagen diseases or hypercoagulable disorders. Renal failure and mesenteric ischemia associated with thromboangiitis obliterans progression was diagnosed.

Conclusions: Renal failure due to renal artery thrombosis and mesenteric ischemia represents an unusual manifestation of thromboangiitis obliterans. But once it occurs, it can be life-threatening. When we care for a patient with thromboangiitis obliterans, we should pay attention to this rare disease course, and encourage cessation of the smoking of tobacco products.

No MeSH data available.


Related in: MedlinePlus

Lower extremity angiography (2004). a Both common iliac arteries showed patent flow without stenosis or occlusion. b The left superficial femoral artery was occluded at its origin (arrow). c The left distal superficial femoral artery was reconstituted by an abnormal corkscrew collateral blood flow from the left deep femoral artery
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Fig1: Lower extremity angiography (2004). a Both common iliac arteries showed patent flow without stenosis or occlusion. b The left superficial femoral artery was occluded at its origin (arrow). c The left distal superficial femoral artery was reconstituted by an abnormal corkscrew collateral blood flow from the left deep femoral artery

Mentions: A 51-year-old Korean man was admitted to our hospital because of severe left flank pain, hematuria, and oliguria for 3 days. Additional complaints included epigastric discomfort and generalized weakness, but he denied fever or emesis. He had a medical history of hypertension for 1 year and TAO for 10 years with intermittent claudication. He had undergone amputation of both of his great toes 10 years prior because of gangrenous change due to TAO. At that time, lower extremity angiography showed that the flow of the right distal portion of the popliteal artery and the proximal portion of the tibiofibular artery were remarkably decreased by occlusion. The left superficial femoral artery was also occluded from its origin, at which collateral arteries had developed (Fig. 1). He took beraprost for TAO but had not stopped smoking tobacco products. He had smoked approximately 1 pack per day for 30 years. Four years later, he underwent repeat angiography of his abdominal aorta and lower extremities because of worsening claudication. Occlusion of his left superficial femoral artery, bilateral tibial, and peroneal arteries had progressed. He had never been diagnosed with diabetes mellitus, collagen disease or cardiac disease.Fig. 1


End stage renal disease caused by thromboangiitis obliterans: a case report.

Yun HJ, Kim DI, Lee KH, Lim SJ, Hwang WM, Yun SR, Yoon SH - J Med Case Rep (2015)

Lower extremity angiography (2004). a Both common iliac arteries showed patent flow without stenosis or occlusion. b The left superficial femoral artery was occluded at its origin (arrow). c The left distal superficial femoral artery was reconstituted by an abnormal corkscrew collateral blood flow from the left deep femoral artery
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4541743&req=5

Fig1: Lower extremity angiography (2004). a Both common iliac arteries showed patent flow without stenosis or occlusion. b The left superficial femoral artery was occluded at its origin (arrow). c The left distal superficial femoral artery was reconstituted by an abnormal corkscrew collateral blood flow from the left deep femoral artery
Mentions: A 51-year-old Korean man was admitted to our hospital because of severe left flank pain, hematuria, and oliguria for 3 days. Additional complaints included epigastric discomfort and generalized weakness, but he denied fever or emesis. He had a medical history of hypertension for 1 year and TAO for 10 years with intermittent claudication. He had undergone amputation of both of his great toes 10 years prior because of gangrenous change due to TAO. At that time, lower extremity angiography showed that the flow of the right distal portion of the popliteal artery and the proximal portion of the tibiofibular artery were remarkably decreased by occlusion. The left superficial femoral artery was also occluded from its origin, at which collateral arteries had developed (Fig. 1). He took beraprost for TAO but had not stopped smoking tobacco products. He had smoked approximately 1 pack per day for 30 years. Four years later, he underwent repeat angiography of his abdominal aorta and lower extremities because of worsening claudication. Occlusion of his left superficial femoral artery, bilateral tibial, and peroneal arteries had progressed. He had never been diagnosed with diabetes mellitus, collagen disease or cardiac disease.Fig. 1

Bottom Line: He also had abdominal angina.Renal failure and mesenteric ischemia associated with thromboangiitis obliterans progression was diagnosed.But once it occurs, it can be life-threatening.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Konyang University College of Medicine, 158 Gwanjeo-dong-ro, Seo-gu, Daejeon, 302-718, South Korea. yhj0927@kyuh.ac.kr.

ABSTRACT

Introduction: Thromboangiitis obliterans or Buerger's disease is a nonatherosclerotic, segmental, inflammatory vasculitis that is strongly associated with tobacco products and commonly affects the small- and medium-sized arteries of the upper and lower extremities. However, the disease can, rarely, involve large central or visceral arteries. We report here the case of end stage renal disease due to renal artery thrombosis caused by thromboangiitis obliterans.

Case presentation: A 51-year-old Korean man who had previously required amputation of both great toes due to thromboangiitis obliterans presented with left flank pain and oliguria. Both his renal arteries were occluded on contrast-enhanced abdominal computed tomography and abdominal angiography. He also had abdominal angina. He had no risk factor of thromboembolism from cardiac origin, atherosclerosis except for tobacco abuse, collagen diseases or hypercoagulable disorders. Renal failure and mesenteric ischemia associated with thromboangiitis obliterans progression was diagnosed.

Conclusions: Renal failure due to renal artery thrombosis and mesenteric ischemia represents an unusual manifestation of thromboangiitis obliterans. But once it occurs, it can be life-threatening. When we care for a patient with thromboangiitis obliterans, we should pay attention to this rare disease course, and encourage cessation of the smoking of tobacco products.

No MeSH data available.


Related in: MedlinePlus